Agenda item

[Councillor J.P. Jenkins declared an interest during consideration of the Business Support & Commissioning Draft Delivery Plan. He remained in the meeting but did not vote.]

The Committee considered the Draft Divisional Delivery Plans for Integrated Services, Commissioning and Business Support and Adult Social Care.  These plans set the strategic actions and measures that the services within the Division would take forward in order for the Council to make progress against its Well-being Objectives, thematic priorities and service priorities.

It was noted that action and measures for the delivery of the Cabinet Vision Statement Commitments were also included. 

A number of questions were raised. The main matters were as follows:

Integrated services Plan

• In response to clarification regarding the Teifi Cluster the Head of Integrated Services advised that the Health Board areas were different to the County areas.  From the Health Board planning perspective, the Teifi part of the cluster fell under Ceredigion County however the Social Care function was the responsibility of Carmarthenshire.  It was noted that in real terms this did not have an impact on services apart from working with a different team for that particular area of the County. 
• In response to a concern raised regarding risk LAS0002 and the fact the Health Board had ceased its contributions towards S.117 placements for older people and physical disabilities, officers explained that this was specifically for residential care and that funding was dependent on the type of client group.  It was noted that there was a 50/50 split from a young adult perspective.  From an older people/physical disability perspective different arrangement had been in place with the Health Board for a while and that attempts had been made at a regional level to attain equity across the different client groups.  Work on developing a regional cross agency policy proposing a 50/50 split across all the groups had commenced but unfortunately, the Health Board took a decision to publish a Health Board only policy as opposed to a partnership policy.  The Committee requested that a letter be sent to the Health Board expressing their concerns regarding the inequality of these funding arrangements.
• Officers advised that legally the Authority’s interpretation was that the S.117 funding should be split 50/50 between the Local Authority and the Health Board however the Health Board’s interpretation was different.  It was further clarified that S.117 was in relation to a particular section of the Mental Health Act.  If a person was detained in hospital under certain sections of the Mental Health Act they would be entitled to aftercare.  As a Local Authority the aim was to look at consistency across all the services.
• In line with the Cabinet Vision to work with Hywel Dda University Health Board to deliver seamless integrated health and social care services wherever possible, it was noted that Hywel Dda had a much delayed programme to open a multi-disciplinary health centre in Cross Hands which would result in the closure of various GP Surgeries in the area.  It was asked if the Authority had consulted with the Health Board regarding the provision of facilities in the centre.  In response officers advised that the programme had reached the final business case stage and that Welsh Government were supportive of the proposal.  The centre would be a multi-agency integrated centre to include Local Authority,  Health Board and Police Services.  The centre would include a vast range of fully integrated services and would provide premises for existing GP surgeries that were currently located in premises that were no longer fit for purpose.  The benefit of co-location would create more resilience for the service along with economic advantages. 
• It was asked if Social Prescribers could be out in the community more and in contact with people who didn’t necessary visit the GP surgery.  It was explained that the current model worked on referrals from GPs and was still a relatively new project.  It was noted that there was now coverage across the County and that eventually it was hoped that the service would evolve to enable referrals from wider sources.  At present the priority was to manage the current demand from the GP surgeries.
• In response to clarification regarding the spend figures for Cwm Aur, the Committee was advised that Cwm Aur was one of the savings proposals agreed by Council.  The scheme was operated by Pobl and unfortunately the flats were underoccupied resulting in the scheme being a high-cost model to run.  It was stated that more cost-effective alternative care arrangements were being put in place.  This would be done through the use of existing domiciliary care frameworks.

Business Support & Commissioning Plan

• With reference to the debt recovery team a question was asked regarding the amount of debt the Authority currently had.  The Senior Business Support Manager advised that he needed to confirm the current level and informed the Committee that it was complicated due to deferred charges accruing daily.  He confirmed that the information would be shared and advised the budget was approximately £16m per annum for residential fees and at any point it could be around 5% of the budget outstanding as a bad debt.  Assurance was given that targeted early interventions were in place within the debt recovery team in an attempt to prevent it becoming a bad debt.

Adult Social Care Plan

• In reference to milestone M4 and the associated risk, an update was requested on the development of the remodelling and the growing of quality, sustainable and effective in-house domiciliary care service.  Officers advised that there had been recruitment and retention issues, but that the situation had improved.  On going recruitment campaigns and bespoke events were being undertaken and that plans were already in place to increase in house services.

·         In relation to concern regarding the ability to fulfil legislative responsibilities due to the of failure to recruit and retain the workforce (particularly in relation to home care, social work and AMHP’s) the Head of Adult Social Care confirmed that this was a concern and that there was a focus on training / attaining qualifications for existing staff and that the staff would be contractually obliged to remain working for the Authority for a minimum of 3 years after gaining their qualification. 

Resolved that: